Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Int J Mycobacteriol. 2020 Apr-Jun;9(2):107-115. doi: 10.4103/ijmy.ijmy_207_19.
To achieve the World Health Organization end TB Strategy, early detection, and prompt treatment of not only pulmonary but also extrapulmonary tuberculosis (EPTB) should be achieved. The most common EPTB is tuberculous lymphadenitis, and the diagnosis is typically time-consuming. This review aimed to identify the best diagnostic pathway for preventing treatment delay and thus further complications. A systematic keyword search was done using four databases and other relevant publications and using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart to search for relevant articles that met the inclusion criteria. The quality of the articles was assessed using Newcastle-Ottawa Scale, and the articles were summarized based on the test for diagnosing tuberculous lymphadenitis. A total of ten articles were included for the synthesis of results, which compared the sensitivity and specificity of each diagnostic test for tuberculous lymphadenitis. The most promising test is the Xpert Mycobacterium tuberculosis/RIF, which has high sensitivity and specificity, but costs much more in comparison to the other tests. An ideal diagnostic method should include the combination of relevant patient history, clinical examination, and laboratory and radiological testing to avoid delays in treatment, misdiagnosis, and further complications.
为实现世界卫生组织终止结核病战略，不仅要实现对肺结核（PTB），还要对肺外结核（EPTB）的早期发现和及时治疗。最常见的 EPTB 是结核性淋巴结炎，其诊断通常很耗时。本综述旨在确定最佳诊断途径，以预防治疗延误，从而避免进一步的并发症。我们使用四个数据库和其他相关出版物进行了系统的关键词搜索，并使用系统评价和荟萃分析的首选报告项目流程图来搜索符合纳入标准的相关文章。使用纽卡斯尔-渥太华量表评估文章的质量，并根据诊断结核性淋巴结炎的检测方法对文章进行总结。共有 10 篇文章被纳入结果综合分析，比较了每种诊断结核性淋巴结炎的检测方法的敏感性和特异性。最有前途的检测方法是 Xpert 分枝杆菌/利福平检测，其具有较高的敏感性和特异性，但与其他检测方法相比，成本更高。理想的诊断方法应包括相关的病史、临床检查以及实验室和影像学检查的综合应用，以避免治疗延误、误诊和进一步的并发症。
